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Arizona rates for HCPCS 95811

Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$232.69 / $290.83 / $427.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.88 / $777.87 / $1,368.66
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$111.42 / $127.00 / $549.00
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$258.77 / $318.50 / $424.18
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$465.22 / $610.94 / $966.45
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.14 / $622.38 / $653.50
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$104.29 / $110.09 / $196.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.72 / $599.62 / $749.53
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$82.79 / $110.38 / $137.97
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$366.93 / $489.24 / $611.54
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$139.38 / $139.38 / $139.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.98 / $945.41 / $1,550.88
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$119.79 / $183.59 / $324.25
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$498.98 / $762.44 / $1,241.17
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$286.83 / $753.90 / $753.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.34 / $889.20 / $6,200.00
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$111.61 / $184.74 / $1,081.48
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$475.20 / $713.25 / $3,875.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.42 / $796.96 / $1,406.40
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$111.24 / $161.28 / $287.29
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$468.13 / $638.16 / $1,112.51